Acceptability of human papillomavirus immunization

The purpose of this study was to examine the attitudes about hypothetical h uman papillomavirus (HPV) vaccines in two groups of women in clinical setti ngs. Twenty adolescent women attending an urban community adolescent health clinic and 20 adult women attending a city health department sexually tran smitted disease (STD) clinic were recruited to participate in individual in terviews. Adolescents were 14-18 years of age (mean 15.6), 75% non-Hispanic white, and 75% sexually experienced. Adults were 20-50 years of age (mean 33.6), 95% African American, and all were sexually experienced. As part of the interview participants ranked nine hypothetical HPV vaccines in order o f acceptability. Each vaccine was uniquely defined as a function of cost ($ 150, $50, or free), efficacy (50% or 90%), disease targeted (genital warts, cervical cancer, or both), and physician recommendation (not mentioned by a physician or specifically recommended). Rankings by adolescents and adult s were highly concordant (Spearman rho = 0.9). Efficacy, physician's recomm endation, and cost influenced rankings most strongly. Ranking decisions wer e often based on complex decision making, in which all characteristics were considered simultaneously. These findings suggest that certain features of an HPV vaccine might significantly affect vaccine acceptability. Vaccine e fficacy, physician endorsement, and cost were particularly salient issues.